Types of stress and How to measure it

How to identify Stress?

Classification of Stress

There are multiple ways to classify stress.

Time based Classification: It all depends on the timeframe. Stress can vary in duration, ranging from temporary to long-term. Short-term stress has a brief duration, while long-term stress persists for a prolonged period. While episodic stress may be shorter in duration, it tends to occur more frequently during work or social interactions [1].

Emotions based Classification: Another way to classify is by the specific emotions involved. Positive stress, also referred to as eustress, is a result of joyful emotions, while negative stress, or distress, stems from negative emotions. Eustress is a powerful force that drives and channels energy, igniting a sense of excitement and boosting performance. Distress, which is a form of stress that has a negative impact, can cause feelings of anxiety or concern. It is an unpleasant experience that can hinder performance and lead to both mental and physical issues. Nevertheless, the build-up of stress can have a significant effect on an individual [2].

Cause based Classification: Another way to classify stress is by its underlying cause. Physical stress can be attributed to factors such as excessive physical work, accidents, operations, or health problems. Psychological stress arises from an individual’s thoughts or aspirations. These stressors can encompass a range of emotions, cognitive challenges, and perceptual factors. Psychosocial stress can arise from difficulties in relationships or marriages, challenges in family dynamics, a limited social support network, or feelings of isolation. Psycho-spiritual stress can arise when there is a conflict between one’s values or ethics and their underlying spiritual beliefs [3].

In addition to these classifications, stress can also be caused by external factors, such as absorbing someone else’s thoughts, beliefs, or burdens. We can call it secondary stress, empathetic stress, or vicarious stress. It’s comparable to secondhand smoke or passive smoking. Living near a smoker can have detrimental effects on one’s health, similar to those experienced by smokers themselves. Living in close proximity to a highly stressful individual can have a significant impact on one’s stress levels [4].

Assessing Stress Levels

There exists a significant inverse correlation between stress and an individual’s overall well-being. When stress levels increase, a person’s health tends to decline, and the opposite is also true. By detecting and addressing stress at an early stage, we can ensure the person’s well-being is safeguarded. Therefore, it is essential to measure stress levels.

There are several biomarkers that can be used to identify signs of stress within the body. Adrenocortical hormones like cortisol and DHEA, adrenomedullary hormones like epinephrine and norepinephrine, salivary alpha-amylase, pro- and anti-inflammatory cytokines, CRP, and stress-sensitive cardiovascular measurements. However, identifying stress through these indicators necessitates sophisticated biochemical laboratories and tests [5].

The Perceived Stress Scale (PSS) is a well-known tool for measuring stress levels [6]. Although the instrument was introduced in 1983, it continues to be a favored option for gaining insights into the impact of various events on our emotions and perceived stress levels. These questions on the scale aim to gather information about your emotions and thoughts over the past month.

Perceived Stress Scale

For each question choose from the following alternatives:
0 – Never 1 – Almost Never 2 – Sometimes 3 – Fairly Often 4 – Very Often

________ l. In the last month, how often have you been upset because of something that happened unexpectedly?
________ 2. In the last month, how often have you felt that you were unable to control the important things in your life?
________ 3. In the last month, how often have you felt nervous and stressed?
________ 4. In the last month, how often have you felt confident about your ability to handle your personal problems?
________ 5. In the last month, how often have you felt that things were going your way?
________ 6. In the last month, how often have you found that you could not cope with all the things that you had to do?
________ 7. In the last month, how often have you been able to control irritations in your life?
________ 8. In the last month, how often have you felt that you were on top of things?
________ 9. In the last month, how often have you been angered because of things that happened that were outside of your control?
________ 10. In the last month, how often have you felt difficulties were piling up so high that you could not overcome them?

• First, reverse your scores for questions 4, 5, 7, and 8. On these 4 questions, change the scores like this: 0 = 4, 1 = 3, 2 = 2, 3 = 1, 4 = 0.
• Now add up your scores for each item to get a total. My total score is ___________.
• Individual scores on the PSS can range from 0 to 40 with higher scores indicating higher perceived stress

► Scores ranging from 0-13 would be considered low stress.
► Scores ranging from 14-26 would be considered moderate stress.
► Scores ranging from 27-40 would be considered high perceived stress.

Different stages of stress

When someone experiences stress without proper management, it can lead to physical or emotional harm in five stages: alarm, resistance, recovery, adaptation, and burnout.

• During the alarm stage, the body’s defenses are activated as a response to the activation of the central nervous system. This stage triggers a fight-or-flight response.
• The next stage involves facing resistance. At this stage, the body starts to undergo repair and restore its normal heart rate, blood pressure, and other functions. The body is working to restore itself to a healthy state by producing anti-inflammatory hormones to soothe and stabilize it.
• Next is Coping, which is a crucial step. It’s all about finding balance and promoting well-being through healthy habits like maintaining a consistent schedule, nourishing your body with a wholesome diet, and prioritizing regular sleep patterns, among other things.
• The next step is adaptation, which can arise from a feeling of being unable to alter circumstances.
• Ultimately, burnout arises when the delicate equilibrium of the body is disrupted. It can lead to a range of physical and emotional issues for the person [7,8].

1. https://www.verywellmind.com/stress-and-health-3145086#toc-types-of-stress
2. https://www.mentalhelp.net/stress/types-of-stressors-eustress-vs-distress/
3. https://www.mentalhelp.net/blogs/types-of-stress-and-their-symptoms/
4. https://cpdonline.co.uk/knowledge-base/mental-health/second-hand-stress/
5. https://pubs.acs.org/doi/10.1021/acssensors.8b00726
6. https://www.das.nh.gov/wellness/Docs%5CPercieved%20Stress%20Scale.pdf
7. https://www.deannalarsonmd.com/blog/stages-of-stress
8. https://www.marathon-health.com/blog/how-do-you-respond-to-stress/

Key Points

• Short-term stress is temporary, while long-term stress persists. Episodic stress is characterized by shorter durations but more frequent occurrences.
• Positive stress, also referred to as eustress, is a result of positive emotions, while negative stress, or distress, is caused by negative emotions.
• The third method of classification focuses on the different sources of stress, such as physical, psychological, psychosocial, and psychospiritual factors.
• Another source of stress can be when someone shares their opinions, beliefs, or problems with you.
• There exists a notable correlation between stress levels and an individual’s overall well-being.
• Stress biomarkers encompass a range of physiological indicators, such as adrenocortical hormones, adrenomedullary hormones, salivary alpha-amylase, pro- and anti-inflammatory cytokines, CRP, and cardiovascular measurements.
• The Perceived Stress Scale (PSS) provides valuable insights into the impact of various situations on our emotions and perceived stress over the past month. It classifies stress levels as low, moderate, or severe perceived stress.
• If an individual experiences stress without proper management, it can result in physical or emotional harm, progressing through five stages: alarm, resistance, recovery, adaptation, and burnout.

Whether stress relieving techniques will work or not